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2.
Br J Gen Pract ; 70(700): e817-e824, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32988955

RESUMO

BACKGROUND: The COVID-19 pandemic has impacted the psychological health and health service utilisation of older adults with multimorbidity, who are particularly vulnerable. AIM: To describe changes in loneliness, mental health problems, and attendance to scheduled medical care before and after the onset of the COVID-19 pandemic. DESIGN AND SETTING: Telephone survey on a pre-existing cohort of older adults with multimorbidity in primary care. METHOD: Mental health and health service utilisation outcomes were compared with the outcomes before the onset of the COVID-19 outbreak in Hong Kong using paired t-tests, Wilcoxon's signed-rank test, and McNemar's test. Loneliness was measured by the De Jong Gierveld Loneliness Scale. The secondary outcomes (anxiety, depression, and insomnia) were measured by the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder tool, and the Insomnia Severity Index. Appointments attendance data were extracted from a computerised medical record system. Sociodemographic factors associated with outcome changes were examined by linear regression and generalised estimating equations. RESULTS: Data were collected from 583 older (≥60 years) adults. There were significant increases in loneliness, anxiety, and insomnia, after the onset of the COVID-19 outbreak. Missed medical appointments over a 3-month period increased from 16.5% 1 year ago to 22.0% after the onset of the outbreak. In adjusted analysis, being female, living alone, and having >4 chronic conditions were independently associated with increased loneliness. Females were more likely to have increased anxiety and insomnia. CONCLUSION: Psychosocial health of older patients with multimorbidity markedly deteriorated and missed medical appointments substantially increased after the COVID-19 outbreak.


Assuntos
Infecções por Coronavirus , Solidão/psicologia , Saúde Mental/tendências , Doenças não Transmissíveis , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral , Atenção Primária à Saúde , Isolamento Social/psicologia , Idoso , Ansiedade/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Comportamento de Busca de Ajuda , Hong Kong/epidemiologia , Humanos , Masculino , Multimorbidade , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/psicologia , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Atenção Primária à Saúde/estatística & dados numéricos , Atenção Primária à Saúde/tendências , Carência Psicossocial , Fatores Sexuais , Distúrbios do Início e da Manutenção do Sono/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-32932667

RESUMO

This systematic review examines and consolidates existing evidence on stigma associated with the top four non-communicable diseases (NCDs)-cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes-and its impact on the lives of people affected. We conducted a systematic literature search in PubMed, PsycINFO, JSTOR, Science Direct, and Web of Science for original research in English that explored health-related stigma among people living with either of the four NCDs. A three-step integrative synthesis of data was conducted. Twenty-six articles (qualitative = 15; quantitative = 11) were selected, with most (n = 15) related to cancers, followed by diabetes (n = 7), chronic respiratory diseases (n = 3), and cardiovascular diseases (n = 1). Blame, shame, and fear were the main causes of stigma, the origin and nature of which differed according to the disease-specific features. The manifestations (enacted and felt stigma) and consequences (social, behavioral, psychological, and medical) of stigma across NCDs were similar. Inconsistencies existed in the conceptualization of stigma processes. To fill this gap, we developed an NCD-related stigma framework. People living with NCDs can experience stigma, which can negatively impact their health, management of their disease, and quality of life. The new framework can help in improving the understanding of the processes and experiences of stigma related to NCDs.


Assuntos
Doenças não Transmissíveis/psicologia , Qualidade de Vida/psicologia , Estigma Social , Diabetes Mellitus/epidemiologia , Humanos , Vergonha
4.
Cochrane Database Syst Rev ; 8: CD013461, 2020 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-32841367

RESUMO

BACKGROUND: Depression is common in people with non-communicable diseases (NCDs) such as cardiovascular disease, diabetes, cancer, and chronic respiratory conditions. The co-existence of depression and NCDs may affect health behaviours, compliance with treatment, physiological factors, and quality of life. This in turn is associated with worse outcomes for both conditions. Behavioural activation is not currently indicated for the treatment of depression in this population in the UK, but is increasingly being used to treat depression in adults. OBJECTIVES: To examine the effects of behavioural activation compared with any control group for the treatment of depression in adults with NCDs. To examine the effects of behavioural activation compared with each control group separately (no treatment, waiting list, other psychological therapy, pharmacological treatment, or any other type of treatment as usual) for the treatment of depression in adults with NCDs. SEARCH METHODS: We searched CCMD-CTR, CENTRAL, Ovid MEDLINE, Embase, four other databases, and two trial registers on 4 October 2019 to identify randomised controlled trials (RCTs) of behavioural activation for depression in participants with NCDs, together with grey literature and reference checking. We applied no restrictions on date, language, or publication status to the searches. SELECTION CRITERIA: We included RCTs of behavioural activation for the treatment of depression in adults with one of four NCDs: cardiovascular disease, diabetes, cancer, and chronic respiratory conditions. Only participants with a formal diagnosis of both depression and an NCD were eligible. Studies were included if behavioural activation was the main component of the intervention. We included studies with any comparator that was not behavioural activation, and regardless of reported outcomes. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane, including independent screening of titles/abstracts and full-text manuscripts, data extraction, and risk of bias assessments in duplicate. Where necessary, we contacted study authors for more information. MAIN RESULTS: We included two studies, contributing data from 181 participants to the analyses. Both studies recruited participants from US hospital clinics; one included people who were recovering from a stroke and the other women with breast cancer. For both studies, the intervention consisted of eight weeks of face-to-face behavioural therapy, with one study comparing to poststroke treatment as usual and the other comparing to problem-solving therapy. Both studies were at risk of performance bias and potential conflict of interest arising from author involvement in the development of the intervention. For one study, risks of selection bias and reporting bias were unclear and the study was judged at high risk of attrition bias. Treatment efficacy (remission) was greater for behavioural activation than for comparators in the short term (risk ratio (RR) 1.53, 95% confidence interval (CI) 0.98 to 2.38; low-certainty evidence) and medium term (RR 1.76, 95% CI 1.01 to 3.08; moderate-certainty evidence), but these estimates lacked precision and effects were reduced in the long term (RR 1.42, 95% CI 0.91 to 2.23; moderate-certainty evidence). We found no evidence of a difference in treatment acceptability in the short term (RR 1.81, 95% CI 0.68 to 4.82) and medium term (RR 0.88, 95% CI 0.25 to 3.10) (low-certainty evidence). There was no evidence of a difference in depression symptoms between behavioural activation and comparators (short term: MD -1.15, 95% CI -2.71 to 0.41; low-certainty evidence). One study found no difference for quality of life (short term: MD 0.40, 95% CI -0.16 to 0.96; low-certainty evidence), functioning (short term: MD 2.70, 95% CI -6.99 to 12.39; low-certainty evidence), and anxiety symptoms (short term: MD -1.70, 95% CI -4.50 to 1.10; low-certainty evidence). Neither study reported data on adverse effects. AUTHORS' CONCLUSIONS: Evidence from this review was not sufficient to draw conclusions on the efficacy and acceptability of behavioural activation for the treatment of depression in adults with NCDs. A future review may wish to include, or focus on, studies of people with subthreshold depression or depression symptoms without a formal diagnosis, as this may inform whether behavioural activation could be used to treat mild or undiagnosed (or both) depressive symptoms in people with NCDs. Evidence from low-resource settings including low- and middle-income countries, for which behavioural activation may offer a feasible alternative to other treatments for depression, would be of interest.


Assuntos
Terapia Comportamental/métodos , Neoplasias da Mama/psicologia , Depressão/terapia , Doenças não Transmissíveis/psicologia , Acidente Vascular Cerebral/psicologia , Adulto , Viés , Conflito de Interesses , Feminino , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Resolução de Problemas , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
5.
PLoS One ; 15(6): e0234257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32598347

RESUMO

PURPOSE: Bhutan, known as a country of happiness, has experienced rapid social changes and the increasing burden of non-communicable diseases (NCDs) that can impact health and happiness. To inform future NCD prevention programs in Bhutan, this study explores knowledge, perception, and the practices of Bhutanese related to NCDs in the context of the philosophy of happiness. METHODOLOGY: Research was conducted in rural and urban communities of Bhutan in 2017 among 79 inhabitants of both genders, aged ≥18. Participants were recruited through purposive sampling with the data collected by in-depth interviews, participatory observation, and anthropometric measurements. Data were analyzed by thematic analysis. RESULTS/DISCUSSION: Across participants, health was considered as an important element of "happiness". However, lifestyle-related NCD risk factors prevailed due to the lack of effective education programs on NCDs and thus the lack of practical knowledge for NCD prevention across society. We further found that the value of happiness "finding happiness in any situation is virtue" was universal as well as other traditional values and customs, shaping people's health behaviors. From these observations, it is recommended that more practical NCD education/prevention programs should be urgently introduced in Bhutan that involve multiple generations, religion authorities, educational settings, and medical services. ORIGINALITY: This is the first comprehensive qualitative study on the NCD-related lifestyle risks among Bhutanese concerning the concept of happiness.


Assuntos
Felicidade , Conhecimentos, Atitudes e Prática em Saúde , Doenças não Transmissíveis/psicologia , Pesquisa Qualitativa , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Butão , Feminino , Humanos , Masculino
6.
Intern Med ; 59(9): 1155-1162, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32378655

RESUMO

Objective To examine the degree of metabolic abnormalities and their association with the sociodemographic background or mental illness/cognitive disability among homeless men in Nagoya, Japan. Methods We interviewed 106 homeless men (aged 54.2±12.7 years) and measured their metabolic parameters. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. Associations between metabolic abnormalities and the sociodemographic background or mental illness/cognitive disability were analyzed. Results There were significant correlations of liver dysfunction (AST≥35 IU, ALT≥35 IU, γ-GTP≥75 IU), hypertension [systolic/diastolic blood pressure (BP) ≥140/90 mmHg], and dyslipidemia (HDL <40 mg/dL) with the history/duration of homelessness (over 2 times/year) and residence status (living on the streets). Although the mean body mass index (BMI), BP, HbA1c, and LDL in participants living in temporary residences were similar to those obtained from the general population data from National Health Nutrition Survey (NHNS) 2016, the systolic/diastolic BP in those living on the street was significantly higher than in the general population, and the HDL in those living in temporary residences was significantly lower than in those reported in the NHNS 2016 data. In the group with cognitive disability, the ALT, TG, and BMI values were significantly higher and the HDL level significantly lower in those living in temporary residences than in those living on the streets. Conclusion Stressful conditions while living on the streets may exacerbate hypertension and liver dysfunction, and unhealthy food habits when living in a temporary residence may exacerbate low HDL levels. In addition, an inability to self-manage due to cognitive disability may increase the ALT, TG, and BMI values. The provision of homeless people with the skills to sustain independent living conditions and ensure a healthy diet is required.


Assuntos
Pessoas em Situação de Rua , Saúde do Homem , Doenças não Transmissíveis/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Demografia , Dislipidemias/sangue , Humanos , Hipertensão/fisiopatologia , Japão/epidemiologia , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Doenças não Transmissíveis/psicologia , Prevalência , Psicometria , Fatores Socioeconômicos , Adulto Jovem
8.
Ter. psicol ; 38(1): 119-129, abr. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1115944

RESUMO

Resumen El objetivo fue identificar las asociaciones entre apoyo social percibido, riesgo suicida y presencia de enfermedad crónica no transmisible en estudiantes universitarios. Utilizando un diseño de casos y controles, con 41 estudiantes universitarios por grupo. La mediana de edad fue de 22 años (R = 9), un 81,8% eran mujeres, el 26,8% de los sujetos tenía Asma y el 26,8% Hipotiroidismo, y el 63,6% pertenecía a la Facultad de Educación. No se comprobó la asociación entre enfermedad crónica, apoyo social, ni tampoco con riesgo suicida. Hay asociación indirecta entre riesgo suicida y apoyo social, no así cuando se evalúa el intento de suicidio previo. El nivel de riesgo suicida y apoyo social se asocian independiente de la presencia de enfermedad crónica. Esperamos que nuestros resultados permitan fomentar el apoyo social como una herramienta fundamental para la prevención de la suicidabilidad, especialmente en sujetos con enfermedad crónica.


Abstract The objective was to identify associations between perceived social support, suicidal risk and the presence of chronic or communicable disease in university students. Using a case-control design, consisting of 41 subjects in each group. The median age was 22 years (R = 9), 81,8% were women, 26,8% of the subjects had asthma and 26,8% had hypothyroidism, 63,6% were students of the faculties of Education. The association between chronic disease and social support was not proven, nor was there a suicidal risk. There is an indirect association between suicide risk and social support, not so when assessing the previous suicide attempt. The levels of suicide risk and social support are associated, independent of an existing chronic disease. We are hopeful that our results will be effective in promoting social support as a basic tool for suicide prevention, especially in subjects with chronic disease.


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Apoio Social , Estudantes/psicologia , Suicídio/psicologia , Doença Crônica/psicologia , Asma/psicologia , Tentativa de Suicídio/psicologia , Universidades , Estudos de Casos e Controles , Chile , Inquéritos e Questionários , Medição de Risco , Autorrelato , Doenças não Transmissíveis/psicologia , Hipotireoidismo/psicologia
10.
Med J Malaysia ; 74(5): 389-393, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31649214

RESUMO

BACKGROUND: Physical inactivity remains the most important modifiable risk factor in preventing a variety of noncommunicable diseases (NCDs) and has been identified to be a risk factor for obesity, heart disease and cancers. This study examined the prevalence and factors associated with physical inactivity among the suburban adult population in Port Dickson district, Negeri Sembilan, Peninsular Malaysia. MATERIAL AND METHODS: This was a community based crosssectional study involving 397 adult respondents conducted in February 2016. Data was collected by face-to-face interview using a structured questionnaire. Data regarding socio-demographic factors (age, gender, ethnicity, education level, marital status and monthly income, working hours), current behavioural stage of physical activity and perceived benefits and barriers to physical activity were collected. Physical activity measured using the International Physical Activity Questionnaire (IPAQ) with the cut-off point of less than 600 met-min per week was considered to be physically inactive. RESULTS: The prevalence of physical inactivity among adult population was 36.3%. Factors significantly associated with physical inactivity included age, gender, marital status, working hours and current behavioural stage of physical activity. CONCLUSION: Physical inactivity is high among the adult community in Negeri Sembilan district, Peninsular Malaysia and was strongly associated with age, gender, marital status, working hours and current behavioural stage of physical activity. It is important to identify individuals with physical inactivity and its associated factors early as this could severely affect the quality of life of the individuals.


Assuntos
Exercício Físico/fisiologia , Doenças não Transmissíveis/prevenção & controle , Qualidade de Vida , Comportamento Sedentário , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/psicologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
11.
BMJ Open ; 9(8): e026390, 2019 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-31399449

RESUMO

OBJECTIVE: To quantify global relationships between sugar-sweetened beverage (SSB) intake and prices and examine the potential effectiveness of tax policy. DESIGN: SSB intake data by country, age and sex from the Global Dietary Database were combined with gross domestic product and price data from the World Bank. Intake responsiveness to income and prices was estimated accounting for national income, age and sex differences. SETTING: 164 countries. POPULATION: Full adult population in each country. MAIN OUTCOME MEASURES: A consumer demand modelling framework was used to estimate the relationship between SSB intake and prices and derive own-price elasticities (measures of percentage changes in intake from a 1% price change) globally by age and sex. We simulated how a 20% tax would impact SSB intake globally. Tax policy outcomes were examined across countries by global income decile for representative age and sex subgroups. RESULTS: Own-price responsiveness was highest in lowest income countries, ranging from -0.70 (p<0.100) for women, age 50, to -1.91 (p<0.001) for men, age 80. In the highest income countries, responsiveness was as high as -0.49 (p<0.001) (men, age 20), but was mostly insignificant for older adults. Overall, elasticities were strongest (more negative) at the youngest and oldest age groups, and mostly insignificant for middle-aged adults, particularly in middle-income and high-income countries. Sex differences were mostly negligible. Potential intake reductions from a 20% tax in lowest income countries ranged from 14.5% (95% CI: 29.5%, -0.4%) in women, 35 ≤ age < 60, to 24.9% (44.4%, 5.3%) in men, age ≥60. Intake reductions decreased with country income overall, and were mostly insignificant for middle-aged adults. CONCLUSIONS: These findings estimate the global price-responsiveness of SSB intake by age and sex, informing ongoing policy discussions on potential effects of taxes.


Assuntos
Comércio , Comportamento Alimentar , Doenças não Transmissíveis/prevenção & controle , Bebidas Adoçadas com Açúcar , Impostos , Fatores Etários , Economia , Feminino , Saúde Global/normas , Saúde Global/estatística & dados numéricos , Humanos , Renda , Internacionalidade , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/economia , Doenças não Transmissíveis/psicologia , Recomendações Nutricionais/economia , Fatores Sexuais , Bebidas Adoçadas com Açúcar/economia , Bebidas Adoçadas com Açúcar/normas , Bebidas Adoçadas com Açúcar/estatística & dados numéricos
12.
Indian J Public Health ; 63(2): 119-127, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31219060

RESUMO

Background: The increasing burden of noncommunicable diseases (NCDs) urges continuous survey of risk factors in different population groups. Objectives: The study was conducted to assess the prevalence and determinants of behavioral and biological risk factors of NCDs, in rural tribal population. Methods: A community-based cross-sectional study was conducted from June 2014 to May 2015, in rural Siliguri, among 172 tribal people aged 25-64 years selected by multistage cluster random sampling using WHO-STEPS instrument. Study participants were interviewed for sociodemographic and behavioral risk factors, and biological measurements were taken. Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. Results: Among the study participants, the prevalence of current tobacco use and alcohol use were 69.8% and 40.7%, respectively; 96.5% consumed unhealthy diet and 2.9% were physically inactive. The prevalence of abdominal obesity and overweight were 26.2% and 12.2%, respectively. Odds of tobacco use were significantly raised among men (adjusted odds ratio [AOR]: 47.7 [95% confidence interval (CI) 11.1, 203.9]) and increased age of the participants. Men showed higher odds of alcohol consumption (AOR: 13.4 [95% CI 4.6, 38.9]). Odds of abdominal obesity were higher among older participants, whereas lower odds were found among men (AOR: 95% CI 0.11 [0.0, 0.5]) compared to women. Conclusions: Most of the behavioral and biological risk factors of NCDs were quite high among tribal population of rural Siliguri except physical inactivity. Increasing awareness about NCDs through locally accepted and culturally appropriate strategies need to be implemented in the study area.


Assuntos
Grupos Étnicos/psicologia , Doenças não Transmissíveis/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/etnologia , Doenças não Transmissíveis/psicologia , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Fatores de Risco , Comportamento Sedentário , Fatores Sexuais , Uso de Tabaco/efeitos adversos , Uso de Tabaco/epidemiologia
13.
Asian J Psychiatr ; 43: 189-196, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31229701

RESUMO

BACKGROUND: Psychological and sociological factors like loneliness have a noteworthy influence on the aging. Very less is known about loneliness amongst the elderly populations living with various Non-communicable diseases. AIM: The present study aimed to evaluate the prevalence and correlates of loneliness among elderly patients with Non-communicable diseases. METHODOLOGY: 296 patients attending the chronic disease clinic of two Community Health Centres were evaluated on University of California, Los Angeles Loneliness Scale (UCLA LS), Geriatric Depression Scale, Generalized Anxiety Disorder (GAD-7 scale) and Vulnerability to Abuse Screening Scale. RESULTS: More than half (55.4%) of the participants experienced loneliness as per the three item UCLA LS. When the total scores of UCLA scale were used to evaluate the severity of loneliness, half of the study participants had either moderate (N = 39; 13.2%), moderately high (N = 52; 17.6%) and high (N = 55; 18.6%) level of loneliness. Higher proportion of patients experiencing loneliness had anxiety and reported abuse. Significant predictors of loneliness included presence of diabetes mellitus or hypertension, generalized anxiety disorder and abuse. CONCLUSION: Older adults living with non-communicable diseases are at a higher risk for loneliness. Mutual help groups kind of models can be developed to help in "re-peopling" elderly. Primary health centres should help in improving the overall health and morale amongst the elderly by stamping down their apprehensions and anxieties.


Assuntos
Envelhecimento/psicologia , Ansiedade/psicologia , Doença Crônica/psicologia , Depressão/psicologia , Maus-Tratos ao Idoso/psicologia , Solidão/psicologia , Doenças não Transmissíveis/psicologia , População Rural , Idoso , Idoso de 80 Anos ou mais , Centros Comunitários de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Serviços de Saúde Rural , Centros de Atenção Terciária
14.
Int J Public Health ; 64(6): 821-830, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31062035

RESUMO

OBJECTIVES: To identify clusters of risk behaviors among Brazilian adults, by sex, and to associate clusters with sociodemographic factors and self-perception of health. METHODS: We assessed 46,785 adults from the Brazilian National Health Survey. The risk behaviors were low consumption of fruits and vegetables-LFV (< 5 times/week), physical inactivity-PI (< 150 min/week), smoking (yes/no) and excessive consumption of alcohol-EA (5 doses for male, 4 doses for female). We used Venn diagram, cluster analysis and multinomial regression models. RESULTS: We found 9 clusters. The cluster of four risk behaviors was more common in males (3.2% vs. 0.83%). Despite a greater potential for aggregation of behaviors in females (O/E = 2.48) than in males (O/E = 1.62), the women were less likely to have all risk behaviors jointly (OR 0.24, 95% CI 0.19; 0.31), and this was found for the other clusters. In general, Brazilian black/brown, younger, with low education level and who had a self-perception of bad health, were more likely to engage in clusters of risk behaviors. CONCLUSIONS: The prevalence of Brazilian adults engaging in clusters of risk behaviors is high, mainly among males, those who reported a bad health and with low socioeconomic status.


Assuntos
Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Doenças não Transmissíveis/psicologia , Assunção de Riscos , Adulto , Brasil/epidemiologia , Análise por Conglomerados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
16.
Invest Educ Enferm ; 37(1)2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31083841

RESUMO

OBJECTIVES: To evaluate the effect of the "Caring for Caregivers" program in the caring ability and burden in family caregivers of patients with chronic diseases at health care institutions. METHODS: A randomized controlled clinical trial was conducted in 34 relatives of patients with chronic diseases that had cared for them for more than 3 months. Zarit scale was used to measure caregiver burden and the CAI (Caring Ability Inventory) was also used to measure caring ability. An educational intervention was applied based on the "Caring for Caregivers" strategy of the Universidad Nacional de Colombia. RESULTS: Although both groups improved their percentage of unburdened caregivers from the first to the second assessment, the difference between the two assessments was 41.2% in the intervention group whereas it was 11.8% in the control group, being only statistically significant the difference for the intervention group. Regarding the caring ability, no significant changes were identified in both groups. CONCLUSIONS: On family caregivers, it was observed that the "Caring for Caregivers" intervention had a positive impact on decreasing burden, but not on improving the caring ability.


Assuntos
Cuidadores/psicologia , Doenças não Transmissíveis/terapia , Papel do Profissional de Enfermagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidadores/educação , Colômbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/psicologia
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(4): 406-411, 2019 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-31006199

RESUMO

Objective: To estimate the health-related quality of life (HRQOL) and health-adjusted life expectancy (HALE) which were associated with chronic non-communicable diseases (NCDs) in people from Guangdong province of China. Methods: Data on both NCDs prevalence and EuroQol-5 Dimensions-3 Levels measured HRQOL were gathered from the Fifth National Health Survey in Guangdong province, 2013. Logistic regression model and multiple linear regression model were employed to explore the impact of NCDs on HRQOL. Life expectancy (LE) and HALE were used to evaluate the comprehensive impact of chronic diseases on population health. Results: A total of 68 550 inhabitants were included in the analysis. Graded logistic regression showed that the impact of chronic diseases on all dimensions of quality of life was statistically significant after adjusting for social demographic characteristics. The greatest health impact was on the pain/discomfort health dimension [OR=4.48 (95%CI:4.20-4.77)], followed by anxiety/depression[OR=3.95 (95%CI: 3.62- 4.31)], daily activities [OR=3.69 (95%CI: 3.37-4.04)], mobility [OR=3.63 (95%CI: 3.34-3.94)]and ability on self-care [OR=3.30 (95%CI: 2.98-3.66)]. Losses of LE and HALE caused by NCDs were 12.7 and 14.6 years respectively while the overall expected gain was 3.8 years in HALE, when NCDs were taken away. Conclusions: Our data showed that NCDs had shortened the healthy life span of patients through reducing the HRQOL and also causing heavy disease burden on both patients with NCDs and the communities. Health-care related policies on NCDs need to be developed, for the elderly, in particular.


Assuntos
Doença Crônica/psicologia , Expectativa de Vida , Doenças não Transmissíveis/psicologia , Qualidade de Vida/psicologia , Idoso , China/epidemiologia , Doença Crônica/etnologia , Humanos , Doenças não Transmissíveis/etnologia , Prevalência
18.
BMC Psychiatry ; 19(1): 81, 2019 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-30813922

RESUMO

BACKGROUND: Depression is a global problem, affecting populations worldwide, but is too often under-diagnosed. The identification of depression among patients with diabetes is important because depression is prevalent in this group and can complicate diabetes management. OBJECTIVES: The aim of the study was to determine the sensitivity and specificity of the PHQ-9 in the detection of depression among patients with type-2 diabetes mellitus attending non-communicable diseases (NCD) clinics in Malawi. METHODS: We conducted a validation study of the Patient Health Questionnaire (PHQ-9) among 323 patients with type-2 diabetes mellitus who attended two NCD clinics in one of the 28 districts of Malawi. The participants were screened consecutively using the nine-item PHQ-9 in Chichewa by a research assistant and completed a diagnostic interview using the Structured Clinical Interview for DSM-IV (SCID) for depression with a mental health clinician. We evaluated both content validity based on expert judgement and criterion validity of the Patient Health Questionnaire (PHQ-9) based on performance against the SCID. The PHQ-9 cutpoint that maximized sensitivity plus specificity was selected to report test characteristics. RESULTS: Using the SCID for depression, the prevalence of minor or major depression was 41% (133/323). The internal consistency estimate for the PHQ-9 was 0.83, with an area under the receiver operator curve (AUC) of 0.93 (95% CI, [0.91-0.96]). Using the optimal cut-point of ≥9, the PHQ-9 had a sensitivity of 64% and a specificity of 94% in detecting both minor and major depression, with likelihood ratio-positive = 10.1 and likelihood ratio negative =0.4 as well as overall correct classification (OCC) rate of 81%. CONCLUSIONS: This is the first validation study of the PHQ-9 in NCD clinics in Malawi. Depression was highly prevalent in this sample. The PHQ-9 demonstrated reasonable accuracy in identifying cases of depression and is a useful screening tool in this setting. Health care workers in NCD clinics can use the PHQ-9 to identify depression among their patients with those having a positive screen followed up by additional diagnostic assessment to confirm diagnosis. TRIAL REGISTRATION: PACTR201807135104799 . Retrospectively registered on 12 July 2018.


Assuntos
Depressão/psicologia , Diabetes Mellitus Tipo 2/psicologia , Doenças não Transmissíveis/psicologia , Questionário de Saúde do Paciente/normas , Adulto , Instituições de Assistência Ambulatorial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Nível de Saúde , Humanos , Malaui , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Inquéritos e Questionários/normas
19.
Ann Glob Health ; 85(1)2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30896134

RESUMO

BACKGROUND: Noncommunicable diseases (NCDs) continue to cause significant morbidity and mortality worldwide with incidence increasing rapidly in developing countries. Poor utilization of preventive healthcare services contributes to this high burden. OBJECTIVE: To assess the knowledge and utilization of preventive healthcare services among women in Lagos, Nigeria. METHODS: This was a cross-sectional descriptive study carried out at Mainland Local Government Area (LGA) between May and July 2014. Respondents were selected using the multistage sampling method. A pretested, interviewer-administered questionnaire was used to obtain information. Data were analyzed using Epi info software version 7. Summary and inferential statistics were done and the level of significance was set at <5% (p < 0.05). FINDINGS: Awareness of specified NCDs among the 322 respondents was 82.61% and of preventive healthcare services for the NCDs was 65.22%. Virtually all (99.05%) of the respondents had poor knowledge of these preventive services. Utilization rates were equally poor. Most common screening/tests done were Blood Pressure measurement (78.18%), Self breast examination (69.96%) and blood sugar test (58.33%). Much lower utilization rates were recorded for lipid profile (37.57%), Pap smear (26.11%), Visual Inspection with Acetic Acid (VIA) (19.72%), Human Papilloma Virus (HPV) immunization (16.55%) and mammography (14.72%). CONCLUSIONS: Respondents were aware of specified NCDs and preventive healthcare services. They considered routine medical check-up important, however they had poor knowledge of the preventive health services for NCDs and hardly utilized them. Women should be given detailed information on the preventive healthcare services to improve their knowledge and utilization so as to reduce the NCD burden.


Assuntos
Acesso aos Serviços de Saúde/normas , Doenças não Transmissíveis , Aceitação pelo Paciente de Cuidados de Saúde , Serviços Preventivos de Saúde , Adulto , Atitude Frente a Saúde , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Nigéria/epidemiologia , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/prevenção & controle , Doenças não Transmissíveis/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/provisão & distribução
20.
J Nerv Ment Dis ; 207(2): 53-58, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30672877

RESUMO

A vast number of veterans with posttraumatic stress disorder (PTSD) have chronic somatic comorbidities. However, their relationship with quality of life (QoL) has received little attention. We aimed to compare QoL of veterans with similar intensity of PTSD but different number of chronic somatic disorders. Of 129 veterans, 78% had at least one somatic disorder, and they reported lower QoL across all domains than veterans without somatic comorbidities. The greatest effect size was observed on social relationship (d = 0.65), it was notable on environment (d = 0.4) and psychological health (d = 0.38), and it was not relevant on physical health (d = 0.05). There was a negative correlation between the number of somatic disorders and scores on psychological health (rs = -0.217, p = 0.014), social relationships (rs = -0.248, p = 0.005), and environment (rs = -0.279, p = 0.001). The QoL of war veterans decreases significantly with the number of comorbid somatic conditions, particularly on the nonphysical domains of QoL.


Assuntos
Distúrbios de Guerra/psicologia , Relações Interpessoais , Doenças não Transmissíveis/psicologia , Qualidade de Vida/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Distúrbios de Guerra/epidemiologia , Comorbidade , Croácia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Veteranos/estatística & dados numéricos
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